Provider Demographics
NPI:1831751676
Name:PEKOE ACUPUNCTURE AND WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:PEKOE ACUPUNCTURE AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURISTT
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:INGRID
Authorized Official - Last Name:MIRES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:202-408-4858
Mailing Address - Street 1:1410 9TH ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3361
Mailing Address - Country:US
Mailing Address - Phone:202-408-4858
Mailing Address - Fax:202-408-4857
Practice Address - Street 1:1410 9TH ST NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3361
Practice Address - Country:US
Practice Address - Phone:202-408-4858
Practice Address - Fax:202-408-4857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCAD66OtherBLUECROSS BLUESHIELD